National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
Topics
- Access to Care (3)
- Adverse Drug Events (ADE) (2)
- Adverse Events (3)
- Blood Thinners (1)
- Cardiovascular Conditions (1)
- Care Coordination (1)
- Care Management (3)
- Children/Adolescents (1)
- Chronic Conditions (3)
- Communication (1)
- Community-Based Practice (1)
- COVID-19 (1)
- Critical Care (1)
- Diabetes (2)
- Elderly (1)
- Emergency Medical Services (EMS) (2)
- Evidence-Based Practice (2)
- Guidelines (1)
- Healthcare Costs (1)
- (-) Healthcare Delivery (16)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (3)
- Heart Disease and Health (1)
- Hospital Discharge (1)
- Hospitals (1)
- Human Immunodeficiency Virus (HIV) (1)
- Implementation (3)
- Inpatient Care (1)
- Medicaid (2)
- Medical Errors (3)
- (-) Medication (16)
- Medication: Safety (1)
- Opioids (5)
- Pain (1)
- Patient-Centered Outcomes Research (1)
- Patient Adherence/Compliance (4)
- Patient Safety (4)
- Patient Self-Management (1)
- Practice Patterns (1)
- Primary Care (3)
- Primary Care: Models of Care (1)
- Provider (1)
- Provider: Pharmacist (1)
- Rural Health (3)
- Social Stigma (1)
- Substance Abuse (3)
- Telehealth (1)
- Transitions of Care (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 16 of 16 Research Studies DisplayedRikin S, Perez HR, Zhang C
Changes in outpatient opioid prescribing during the COVID-19 pandemic: an interrupted time series analysis.
Changes in health care delivery during the COVID-19 pandemic may have impacted opioid prescribing. This study evaluated the impact of restrictions on in-person care on opioid prescribing in the outpatient setting. The hypothesis was that after restrictions to in-person care were implemented, there would be a reduction in the number of chronic and non-chronic opioid prescriptions.
AHRQ-funded; HS026396.
Citation: Rikin S, Perez HR, Zhang C .
Changes in outpatient opioid prescribing during the COVID-19 pandemic: an interrupted time series analysis.
J Prim Care Community Health 2022 Jan-Dec;13:21501319221076926. doi: 10.1177/21501319221076926..
Keywords: COVID-19, Opioids, Medication, Practice Patterns, Healthcare Delivery
Flynn G, Jia H, Reynolds NR
Protocol of the randomized control trial: the WiseApp trial for improving health outcomes in PLWH (WiseApp).
This paper outlines the protocol for the WiseApp randomized control trial. The WiseApp contains real-time medication monitoring linking an electronic pill bottle and fitness tracker to the app, helping persons living with HIV (PLWH) self-manage their medication adherence and improve their overall quality of life. The primary objective of the trial is to test the effect of the WiseApp's medication adherence features on antiretroviral adherence in underserved PLWH in New York City. The real-time monitoring of the WiseApp has the potential to help providers initiate interventions to help patients resume treatment before drug resistance begins.
AHRQ-funded; HS025071.
Citation: Flynn G, Jia H, Reynolds NR .
Protocol of the randomized control trial: the WiseApp trial for improving health outcomes in PLWH (WiseApp).
BMC Public Health 2020 Nov 25;20(1):1775. doi: 10.1186/s12889-020-09688-0..
Keywords: Human Immunodeficiency Virus (HIV), Medication, Telehealth, Health Information Technology (HIT), Patient Adherence/Compliance, Patient Self-Management, Chronic Conditions, Care Management, Healthcare Delivery
Jones AE, King JB, Kim K
The role of clinical pharmacy anticoagulation services in direct oral anticoagulant monitoring.
The objective of this study was to describe direct oral anticoagulant (DOAC) management in patients who were and were not managed by an anticoagulation management service (AMS). Subjects were patients with atrial fibrillation at the University of Utah Health (UUH) who received DOAC therapy. Results showed that patients managed by AMS providers were more complex and had more frequent encounters regarding their DOAC therapy than those managed by non-AMS providers. However, there was evidence of duplicative DOAC therapy management efforts. No difference between AMS and non-AMS groups in the composite clinical endpoint was detected.
AHRQ-funded; HS026156.
Citation: Jones AE, King JB, Kim K .
The role of clinical pharmacy anticoagulation services in direct oral anticoagulant monitoring.
J Thromb Thrombolysis 2020 Oct;50(3):739-45. doi: 10.1007/s11239-020-02064-0..
Keywords: Blood Thinners, Medication, Provider: Pharmacist, Provider, Care Management, Healthcare Delivery
Green TC, Donovan E, Klug B
Revisiting pharmacy-based naloxone with pharmacists and naloxone consumers in 2 states: 2017 perspectives and evolving approaches.
The authors sought to examine similarities and differences in experiences obtaining naloxone at the pharmacy over a 1-year period in 2 states, and to explore reactions from people with opioid use disorder, patients taking opioids for chronic pain, caregivers of opioid users, and pharmacists to communication tools and patient outreach materials designed to improve naloxone uptake. Through focus groups in Massachusetts and Rhode Island, they found that experiences dispensing naloxone are quickly evolving, and a greater diversity of patients are obtaining pharmacy naloxone. They concluded that persistent stigma-related concerns underscore the need for tools to help pharmacists offer naloxone, facilitate patient requests, and provide reassurance when getting naloxone.
AHRQ-funded; HS024021.
Citation: Green TC, Donovan E, Klug B .
Revisiting pharmacy-based naloxone with pharmacists and naloxone consumers in 2 states: 2017 perspectives and evolving approaches.
J Am Pharm Assoc (2003) 2020 Sep-Oct;60(5):740-49. doi: 10.1016/j.japh.2020.03.005..
Keywords: Opioids, Medication, Substance Abuse, Community-Based Practice, Healthcare Delivery, Social Stigma, Access to Care
Parchman ML, Ike B, Osterhage KP
Barriers and facilitators to implementing changes in opioid prescribing in rural primary care clinics.
This paper discusses the barriers and facilitators to implementing changes in opioid prescription in rural areas using the Six Building Blocks evidence-based program to reduce opioid prescription in primary care practices. The program was implemented at 6 rural and rural-serving organizations with 20 clinic locations over a 15-month period. Interviews and focus groups with conducted with the organizations at the end of the program period. Facilitators included a desire to help patients and their community; external pressures to make changes in opioid management; a desire to reduce workplace stress; external support for the clinic; supportive clinic leadership; and receptivity of patients. Barriers included competing demands on clinicians and staff; a culture of clinician autonomy; inadequate data systems; and a lack of patient resources in rural areas.
AHRQ-funded; HS023750.
Citation: Parchman ML, Ike B, Osterhage KP .
Barriers and facilitators to implementing changes in opioid prescribing in rural primary care clinics.
J Clin Transl Sci 2020 Jan 10;4(5):425-30. doi: 10.1017/cts.2019.448..
Keywords: Opioids, Medication, Rural Health, Primary Care, Primary Care: Models of Care, Implementation, Pain, Chronic Conditions, Healthcare Delivery
Mixon AS, Kripalani S, Stein J
An on-treatment analysis of the MARQUIS study: interventions to improve inpatient medication reconciliation.
This paper examined evidence-based interventions implemented in five US hospitals to improve inpatient medication reconciliation. The sites implemented one to seven interventions in 791 patients during a 25-month implementation period. Three interventions were associated with significant decreases in potentially harmful reconciliation rates while two interventions were associated with significant increases. The positive interventions included: defining clinical roles and responsibilities, training, and hiring staff to perform discharge medication reconciliation. The negative interventions were training staff to take medication histories and implementing a new electronic health record (EHR) system.
AHRQ-funded; HS019598.
Citation: Mixon AS, Kripalani S, Stein J .
An on-treatment analysis of the MARQUIS study: interventions to improve inpatient medication reconciliation.
J Hosp Med 2019 Oct;14(10):614-17. doi: 10.12788/jhm.3308..
Keywords: Medication, Evidence-Based Practice, Adverse Drug Events (ADE), Adverse Events, Medical Errors, Patient Safety, Hospitals, Healthcare Delivery, Inpatient Care
Cochran G, Cole ES, Warwick J
Rural access to MAT in Pennsylvania (RAMP): a hybrid implementation study protocol for medication assisted treatment adoption among rural primary care providers.
This paper reports the design and protocol of an implementation study seeking to advance availability of medication-assisted treatment (MAT) for opioid use disorder (OUD) in rural Pennsylvania counties for patients insured by Medicaid in primary care settings. Results showed an urgent need in the US to expand access to high quality, evidence-based OUD treatment, particularly in rural areas where capacity is limited for service delivery, in order to improve patient health and protect lives. Further, results of this study will provide needed evidence in the field for appropriate methods for implementing MAT among a large number of rural primary care providers.
AHRQ-funded; HS025072.
Citation: Cochran G, Cole ES, Warwick J .
Rural access to MAT in Pennsylvania (RAMP): a hybrid implementation study protocol for medication assisted treatment adoption among rural primary care providers.
Addict Sci Clin Pract 2019 Aug 1;14(1):25. doi: 10.1186/s13722-019-0154-4..
Keywords: Opioids, Substance Abuse, Rural Health, Medication, Access to Care, Implementation, Primary Care, Healthcare Delivery, Medicaid
Wyatt DL
AHRQ Author: Wyatt DL
Employing technology to make care transitions safer.
This commentary discusses the potential for errors in patient handoffs; important information about medications and instructions regarding patient care may be overlooked when the patient is referred to special care, moved to a new hospital setting, or discharged. The problem is especially acute for patients with multiple chronic conditions who often undergo frequent transitions to new care settings and healthcare providers. The author describes AHRQ’s funding opportunities for health information technology interventions that aim to improve communication and coordination during care transitions, such as location-based smartphone alerts, a patient-centered discharge toolkit, and a ‘smart pillbox’ electronic medication adherence reporting project.
AHRQ-authored.
Citation: Wyatt DL .
Employing technology to make care transitions safer.
J Nurs Care Qual 2019 Jul/Sep;34(3):185-88. doi: 10.1097/ncq.0000000000000417..
Keywords: Adverse Events, Care Coordination, Chronic Conditions, Communication, Health Information Technology (HIT), Healthcare Delivery, Hospital Discharge, Medical Errors, Medication, Patient Safety, Transitions of Care
Cole ES, DiDomenico E, Cochran G
The role of primary care in improving access to medication-assisted treatment for rural Medicaid enrollees with opioid use disorder.
The authors examined the degree to which rural residents with opioid use disorder (OUD) are engaged with primary care providers (PCPs); they also described the role of rural PCPs in medication-assisted treatment (MAT) delivery, and estimated the association between enrollee distance to MAT prescribers and MAT utilization. They concluded that PCP utilization among rural Medicaid enrollees diagnosed with OUD is high, presenting a potential intervention point to treat OUD, particularly if the enrollee's PCP is located nearer than their MAT prescriber.
AHRQ-funded; HS025072.
Citation: Cole ES, DiDomenico E, Cochran G .
The role of primary care in improving access to medication-assisted treatment for rural Medicaid enrollees with opioid use disorder.
J Gen Intern Med 2019 Jun;34(6):936-43. doi: 10.1007/s11606-019-04943-6..
Keywords: Opioids, Substance Abuse, Rural Health, Medication, Access to Care, Implementation, Primary Care, Healthcare Delivery, Medicaid
Schiff G, Mirica MM, Dhavle AA
A prescription for enhancing electronic prescribing safety.
The authors review six areas in which electronic prescribing areas can be improved to transform medication ordering quality and safety. They recommend incorporating medication indications into electronic prescribing, establishing a single shared online medication list, implementing an electronic cancellation mechanism for pharmacies, implementing standardized structured and codified prescription instruction, reengineering clinical decision support, and redesigning electronic prescribing to facilitate ordering of nondrug alternatives.
AHRQ-funded; HS023694.
Citation: Schiff G, Mirica MM, Dhavle AA .
A prescription for enhancing electronic prescribing safety.
Health Aff 2018 Nov;37(11):1877-83. doi: 10.1377/hlthaff.2018.0725..
Keywords: Adverse Drug Events (ADE), Adverse Events, Health Information Technology (HIT), Healthcare Delivery, Medical Errors, Medication, Medication: Safety, Patient Safety
Maciejewski ML, Hammill BG, Bayliss EA
Prescriber continuity and disease control of older adults.
The objective of this study was to examine whether glycemic control or lipid control was associated with the number of prescribers of cardiometabolic medications. It concluded that multiple prescribers were associated with worse disease control, possibly because patients with more severe diabetes or dyslipidemia have multiple prescribers or because care fragmentation is associated with worse disease control.
AHRQ-funded; HS023085.
Citation: Maciejewski ML, Hammill BG, Bayliss EA .
Prescriber continuity and disease control of older adults.
Med Care 2017 Apr;55(4):405-10. doi: 10.1097/mlr.0000000000000658.
.
.
Keywords: Elderly, Medication, Diabetes, Patient Adherence/Compliance, Healthcare Delivery
Michelson KA, Bachur RG, Levy JA
The impact of critically ill children on paediatric ED medication timeliness.
The presence of critically ill patients may impact care for other ED patients. The researchers evaluated whether the presence of a critically ill child was associated with the time to (1) receipt of the first medication among other patients, and (2) administration of diagnosis-specific medications. They concluded that the presence of critically ill patients was associated with a delay in medication administration to others.
AHRQ-funded; HS000063.
Citation: Michelson KA, Bachur RG, Levy JA .
The impact of critically ill children on paediatric ED medication timeliness.
Emerg Med J 2017 Jan;34(1):8-12. doi: 10.1136/emermed-2016-205989.
.
.
Keywords: Children/Adolescents, Critical Care, Medication, Emergency Medical Services (EMS), Healthcare Delivery
Manojlovich M, Ratz D, Miller MA
AHRQ Author: Miller MA
Use of daily interruption of sedation and early mobility in US hospitals.
Although the Awakening and Breathing Coordination, Delirium assessment, and Early exercise/mobility (ABCDE) bundle may be effective, individual components of ABCDE may not be implemented as intended. The researchers examined the use of daily interruption of sedation and early mobility, looking for an association between these bundle elements.
AHRQ-authored.
Citation: Manojlovich M, Ratz D, Miller MA .
Use of daily interruption of sedation and early mobility in US hospitals.
J Nurs Care Qual 2017 Jan/Mar;32(1):71-76. doi: 10.1097/ncq.0000000000000222.
.
.
Keywords: Evidence-Based Practice, Guidelines, Medication, Patient Safety, Healthcare Delivery
Lyles CR, Seligman HK, Parker MM
Financial strain and medication adherence among diabetes patients in an integrated health care delivery system: The Diabetes Study of Northern California (DISTANCE).
The researchers examined self-reported financial strain in relation to pharmacy utilization adherence data. Their analysis of survey, administrative, and electronic medical data from Kaiser Permanente Northern California found that 8 percent and 9 percent reported general and medication-specific financial strain. In adjusted models, general strain was significantly associated with primary nonadherence and refilling late and medication-specific strain was ssociated with primary nonadherence.
AHRQ-funded; HS022408.
Citation: Lyles CR, Seligman HK, Parker MM .
Financial strain and medication adherence among diabetes patients in an integrated health care delivery system: The Diabetes Study of Northern California (DISTANCE).
Health Serv Res 2016 Apr;51(2):610-24. doi: 10.1111/1475-6773.12346.
.
.
Keywords: Diabetes, Medication, Patient Adherence/Compliance, Healthcare Costs, Healthcare Delivery
Tataris KL, Mercer MP, Govindarajan P
Prehospital aspirin administration for acute coronary syndrome (ACS) in the USA: an EMS quality assessment using the NEMSIS 2011 database.
The researchers sought to determine (1) the proportion of patients with suspected cardiac ischaemia who received aspirin and (2) patient and prehospital characteristics that independently predicted administration of aspirin. Patients living in the Southern region of the USA and patients with governmental (federally administered such as Veteran's Health Care, but not Medicare or Medicaid) insurance had the lowest odds of receiving aspirin.
AHRQ-funded; HS017965.
Citation: Tataris KL, Mercer MP, Govindarajan P .
Prehospital aspirin administration for acute coronary syndrome (ACS) in the USA: an EMS quality assessment using the NEMSIS 2011 database.
Emerg Med J 2015 Nov;32(11):876-81. doi: 10.1136/emermed-2014-204299.
.
.
Keywords: Cardiovascular Conditions, Care Management, Emergency Medical Services (EMS), Heart Disease and Health, Healthcare Delivery, Medication
Rashid N, Coburn BW, Wu YL
Modifiable factors associated with allopurinol adherence and outcomes among patients with gout in an integrated healthcare system.
The investigators identified modifiable patient and provider factors associated with allopurinol adherence and the achievement of a serum urate acid (SUA) goal in gout. They found that among patients with gout initiating allopurinol in their study, 68% did not reach the SUA goal and 57% were nonadherent. They concluded that modifiable factors, including allopurinol dose escalation, treatment adherence, rheumatology referral, and concomitant medication use, could be important factors to consider in efforts aimed at optimizing gout treatment outcomes.
AHRQ-funded; HS018517.
Citation: Rashid N, Coburn BW, Wu YL .
Modifiable factors associated with allopurinol adherence and outcomes among patients with gout in an integrated healthcare system.
J Rheumatol 2015 Mar;42(3):504-12. doi: 10.3899/jrheum.140588.
.
.
Keywords: Healthcare Delivery, Healthcare Utilization, Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research